Chronic Pain Acceptance Predicts Disability

Now a growing body of clinical evidence suggests that while pain may be inevitable, suffering is not — and the key may be a behavioral approach of acceptance.

Up to 80% of people with chronic pain must endure the condition for lack of a medical or surgical solution.1 Now a growing body of clinical evidence suggests that while pain may be inevitable, suffering is not — and the key may be a behavioral approach of acceptance.1,2

In a 2015 Veterans Health Administration (VHA) study of 117 trauma-exposed war veterans, acceptance of chronic pain was found to be the most powerful predictor of disability.

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Published online July 15 in Behaviour Research and Therapy,1 the findings support prior research linking chronic pain acceptance to decreased disability, reduced distress, and improved psychological well-being.2

Acceptance Predicts Disability Despite Pain Severity, Other Factors

The aim of the study was to determine whether acceptance of chronic pain would predict current and 1-year disability beyond the effects of post-traumatic stress disorder (PTSD), depression, alcohol-related problems, mild traumatic brain injury (mTBI), and pain severity.

Chronic pain acceptance was evaluated using a modified version of the Chronic Pain Acceptance Questionnaire (CPAQ); disability was measured using The World Health Organization Disability Assessment Schedule 2.0 self-report version (WHODAS 2.0).

Results showed that higher chronic pain acceptance predicted lower disability (at both baseline and 1 year follow-up), after controlling for symptoms of PTSD, depression, alcohol-related problems, and mTBI.

Importantly, the association remained significant even after adjusting for chronic pain severity.1

“We expected chronic pain acceptance to be a strong predictor of disability. But we were surprised to find that at one year, it was the only significant predictor of disability, even in subjects with more severe pain,” corresponding author Eric C. Meyer, PhD, told Clinical Pain Advisor in an interview. Dr. Meyer is a psychologist with the Central Texas Veterans Health Care System in Waco, Texas.